Grace E Dean1, Patricia Ziegler2, Hongbin Chen3, Lynn M Steinbrenner2,4, Suzanne S Dickerson5. 1. School of Nursing, University at Buffalo, State University of New York, 3435 Main Street, 301 Wende Hall, Buffalo, NY, 14214, USA. gdean@buffalo.edu. 2. VA Western New York Health Systems, Buffalo, NY, USA. 3. Department of Medicine, Thoracic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. 4. School of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA. 5. School of Nursing, University at Buffalo, State University of New York, 3435 Main Street, 301 Wende Hall, Buffalo, NY, 14214, USA.
Abstract
CONTEXT: A knowledge gap exists in our understanding of the illness and insomnia symptom treatment trajectory in adults with inoperable non-small cell lung cancer (NSCLC). OBJECTIVES: Compare valid and reliable sleep-wake measures for insomnia to interpretations of narrative descriptions of sleep to improve our comprehension of sleep-wake disturbances in adults with NSCLC. METHODS: This study employed mixed methods (quantitative and qualitative) in a longitudinal design to study adults (n = 26) from ambulatory thoracic clinics. Valid and reliable surveys (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale), 7-day sleep diary, and actigraphy were obtained with interview narrative interpretations of sleep experiences in the context of lung cancer. Data collection occurred at four-time points: baseline (before chemotherapy), pre-second chemotherapy, pre-third chemotherapy, and 6 months from baseline. Sleep measures were compared to interpretations from interview narratives to understand context of survey measures. RESULTS: Objective quantitative results were congruent with interview narrative interpretations that reflected participants' sleep-wake experiences. Objective sleep-wake measures for insomnia over-time described increasing sleep latency and decreasing sleep duration. The interview narratives provided context and insight into participants' subjective insomnia experiences. While participants' insomnia symptoms were present, they were resigned to endure insomnia, and the subjective measures reflected a more positive perception of sleep outcomes. CONCLUSION: A mixed methods approach provides a deeper understanding of sleep-wake disturbances and the differing quantitative objective and subjective results of sleep measures in the context of the participants' experience of the trajectory of insomnia symptoms before, during, and after lung cancer treatment.
CONTEXT: A knowledge gap exists in our understanding of the illness and insomnia symptom treatment trajectory in adults with inoperable non-small cell lung cancer (NSCLC). OBJECTIVES: Compare valid and reliable sleep-wake measures for insomnia to interpretations of narrative descriptions of sleep to improve our comprehension of sleep-wake disturbances in adults with NSCLC. METHODS: This study employed mixed methods (quantitative and qualitative) in a longitudinal design to study adults (n = 26) from ambulatory thoracic clinics. Valid and reliable surveys (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale), 7-day sleep diary, and actigraphy were obtained with interview narrative interpretations of sleep experiences in the context of lung cancer. Data collection occurred at four-time points: baseline (before chemotherapy), pre-second chemotherapy, pre-third chemotherapy, and 6 months from baseline. Sleep measures were compared to interpretations from interview narratives to understand context of survey measures. RESULTS: Objective quantitative results were congruent with interview narrative interpretations that reflected participants' sleep-wake experiences. Objective sleep-wake measures for insomnia over-time described increasing sleep latency and decreasing sleep duration. The interview narratives provided context and insight into participants' subjective insomnia experiences. While participants' insomnia symptoms were present, they were resigned to endure insomnia, and the subjective measures reflected a more positive perception of sleep outcomes. CONCLUSION: A mixed methods approach provides a deeper understanding of sleep-wake disturbances and the differing quantitative objective and subjective results of sleep measures in the context of the participants' experience of the trajectory of insomnia symptoms before, during, and after lung cancer treatment.
Authors: Susan L Beck; Anna L Schwartz; Gail Towsley; William Dudley; Andrea Barsevick Journal: J Pain Symptom Manage Date: 2004-02 Impact factor: 3.612
Authors: Amy J Hoffman; Barbara A Given; Alexander von Eye; Audrey G Gift; Charles W Given Journal: Oncol Nurs Forum Date: 2007-07 Impact factor: 2.172
Authors: R D Levin; M A Daehler; J F Grutsch; J Quiton; C G Lis; C Peterson; D Gupta; K Watson; D Layer; S Huff-Adams; B Desai; P Sharma; M Wallam; M Delioukina; P Ball; M Bryant; M Ashford; D Copeland; M Ohmori; P A Wood; W J M Hrushesky Journal: Br J Cancer Date: 2005-11-28 Impact factor: 7.640